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    The ophthalmic technology flood

    How much high tech do we need for our practices?

    Today, a visit to the commercial exhibitions of major meetings is a real show, with companies’ booths offering amazing high-tech devices that promise to address the specific needs we have in our practices.

    Although such technology impresses us, we seldom receive information on the evidence-based data surrounding its effectiveness, its cost-benefit analysis and the potential for obsolescence.

    In the past, clinical demands were met by simple market demand. Today, this formula is inverted: the industry supplies us with technology or instruments that they suggest we use for specific conditions or surgical procedures, despite nobody having demanded it.

    Companies try to create a market. For example, when Steve Jobs created the iPad, initially, nobody understood what it was going to be used for.

    There are many ophthalmic examples of this invasion, or ‘flood’ of inadequately proven technologies. The most relevant of all is femtosecond laser-assisted cataract surgery, which, in spite of the huge interest raised and, indeed, the amazing amount of technology that has been incorporated1, to date, has not demonstrated any particular value to our patients2,3.

    Conversely, it results in a negative cost benefit for the surgeon4,5,6, who has to invest a large amount of money without—as is the case in many countries—a clear return.

    Another example is the marking devices for toric lenses and intraoperative ocular aberrometry, which provide a sophisticated link between the corneal topographer and the new intelligent (so-called) microscopes, in order to obtain an adequate alignment in the IOL.

    So far, no prospective clinical study has been published demonstrating any particular difference in the outcomes obtained by these devices versus the conventional ones, and yet the cost of one technology compared with another is overwhelming.

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